Community engagement (CE) is critical for advancing health equity and a key approach for promoting inclusive clinical and translational science. However, it requires a workforce trained to effectively design, implement, and evaluate health promotion and improvement strategies through meaningful collaboration with community members. This paper presents an approach for designing CE curricula for research, education, clinical care, and public health learners. A general pedagogical framework is presented to support curriculum development with the inclusion of community members as facilitators or faculty. The overall goal of the curriculum is envisioned as enabling learners to effectively demonstrate the principles of CE in working with community members on issues of concern to communities to promote health and well-being. We highlight transformations needed for the commonly used critical service-learning model and the importance of faculty well-versed in CE. Courses may include didactics and practicums with well-defined objectives and evaluation components. Because of the importance of building and maintaining relationships in CE, a preparatory phase is recommended prior to experiential learning, which should be guided and designed to include debriefing and reflective learning. Depending on the scope of the course, evaluation should include community perspectives on the experience.

Background: In June 2019, 3 people were diagnosed with Ebola virus disease (EVD) in Kasese district, Uganda, all of whom had come from the Democratic Republic of Congo (DRC). Although no secondary transmission of Ebola occurred, an assessment of infection prevention and control (IPC) using the WHO basic IPC facility assessment checklist revealed significant gaps. Robust IPC systems are critical for the prevention of healthcare-associated infections like EVD. A rapid intervention was developed and implemented in Kasese to strengthen IPC capacity in high-risk facilities. Methods: Of 117 healthcare facilities, 50 were considered at high risk of receiving suspected EVD cases from DRC based on population movement assessments. In August 2019, IPC mentors were selected from 25 high-risk facilities and assigned to support their facility and a second high-risk facility. Mentors ensured formation of IPC committees and implemented the national mentorship strategy for IPC preparedness in non-EVD treatment facilities. This effort focused on screening, isolation, and notification of suspect cases: 4 mentorship visits were conducted (1 per week for 1 month). Middle and terminal assessments were conducted using the WHO IPC checklist 2 and 4 weeks after the intervention commenced. Results were evaluated against baseline data. Results: Overall, 39 facilities had data from baseline, middle, and end assessments. Median scores in facility IPC standard precautions increased from baseline 50% (IQR, 39%–62%) to 73% (IQR, 67%–76%) at the terminal assessments. Scores increased for all measured parameters except for water source (access to running water). Greatest improvements were seen in formation of IPC committees (41% to 75%), hand hygiene compliance (47% to 86%), waste management (51% to 83%), and availability of dedicated isolation areas (16% to 42%) for suspect cases. Limited improvement was noted for training on management of suspect isolated cases and availability of personal protective equipment (PPE) (Fig. 1). No differences were noted in scores for facilities with nonresident mentors versus those with resident mentors at baseline (48% vs 50%) and end assessments (72% vs 74%). Conclusions: This intervention improved IPC capacity in health facilities while avoiding the cost and service disruption associated with large-scale classroom-based training of health workers. The greatest improvements were seen in activities relying on behavior change, such as hand hygiene, IPC committee, and waste management. Smaller changes were seen in areas requiring significant investments such as isolation areas, steady water source, and availability of personal protective equipment (PPE). Mentorship is ongoing in moderate- and lower-risk facilities in Kasese district.

Funding: None

Disclosures: Mohammed Lamorde reports contract research for Janssen Pharmaceutica, ViiV, Mylan.

A common property regime was established at the founding of the Maya site of Actuncan, Belize, in the Terminal Preclassic period (175 BC–AD 300), which governed access to land until the Terminal Classic period (AD 780–1000). This interpretation is based on urban settlement patterns documented through household excavation and remote-sensing programs. Excavations of all visible patio-focused groups in the urban core provided data to reconstruct residential histories, and a 60,621 m2 gradiometer survey resulted in a magnetic gradient map that was used to document buried constructions. Twenty ground-truth testpits correlated types of magnetic signatures to buried patio-focused groups and smaller constructions, including walled plots in agricultural field systems that were later exposed more fully through large-scale excavations. Combined, these methods provided data to reconstruct four correlates of land tenure systems: (1) the spatial proximity of residential units to land and resources, (2) diachronic changes in community settlement patterns, (3) land subdivision and improvements, and (4) public goods. Spatial analyses documented that houselots did not cluster through time, but instead became gradually improved, lending evidence to suggest the transgenerational inheritance of property rights in the Late and Terminal Classic periods.

OBJECTIVES/SPECIFIC AIMS: Chlamydia trachomatis (CT) infection can lead to reproductive morbidity in women. Animal models suggest that protection against CT is mediated through the cytokine interferon-gamma (IFN-γ), produced by CD4+ T-cells, which clears CT through intracellular tryptophan depletion. In humans, correlates of protection remain to be elucidated, which hinders chlamydia vaccine development. Natural clearance of CT infection (e.g., clearance before antibiotics) may be an immunological correlate of protection, evidenced by (1) CT clearance without antibiotics; and (2) a 4-fold reduced risk of CT reinfection within 6 months. We have identified women with and without natural clearance of CT infection. By comparing these two groups of women, the role of IFN-γ-mediated natural clearance of CT infection will be investigated. METHODS/STUDY POPULATION: Through collaboration with a cohort study of CT-infected women, we have access to stored specimens from women who naturally cleared CT or had persisting CT infection. Using peripheral blood mononuclear cell (PBMC), we will assess whether natural clearance of CT infection is associated with IFN-γ-producing CD4+ T-cells by stimulating PBMC ex vivo with CT antigens using intracellular cytokine staining. We will also use cervicovaginal lavage (CVL) and untargeted High-Performance Liquid Chromatography-Mass Spectrometry to assess for tryptophan-dependent and -independent metabolic pathways associated with natural clearance of CT infection. RESULTS/ANTICIPATED RESULTS:: To date, IFN-γ has been measured in 10 women who did not clear CT infection, demonstrating that <20% of these women produced significant levels of IFN-γ. Women who naturally cleared CT have yet to be studied. Untargeted HPLC-MS has been performed on 6 women (3 who cleared matched to 3 with persisting CT infection). To date, 11 pathways that are significantly associated with natural clearance have been identified. DISCUSSION/SIGNIFICANCE OF IMPACT: The outcome of natural clearance of CT infection is distinct from women with persisting chlamydia. These studies may inform whether IFN-γ, produced by CD4+ T-cells, or tryptophan-dependent or -independent metabolic pathways are associated with natural clearance, which may advance chlamydia vaccine development.